Obamacare's effect: The chronically ill

By Tracy Seipel tseipel@mercurynews.com

Posted:
09/28/2013 04:00:00 PM PDT

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Kathryn Johnson at her Capitola home Saturday, Sept. 21, 2013. She pays a large health care premium every month. On the eve of the Oct. 1 kickoff when Americans can start shopping for insurance under the U.S. Affordable Care Act, many Bay Area residents still aren't sure what it means to them, or how the state's healthcare exchange and subsidies work. (Patrick Tehan/Bay Area News Group)

Kathryn Johnson pays a steep price for having asthma and chronic back pain -- $31,044 a year, to be exact.

That's the cost of her health insurance policy, an amount that represents almost half her annual income. And that doesn't include her co-pays or the cost of her prescription medication, which the Capitola woman estimates add up to another $4,000.

"I don't have a lot of options," said Johnson, 57, who lives with her retired husband, who is on Medicare. "This system is so broken. If you're lucky enough to work for a corporation that pays for your health care, you don't understand this. You don't know that people like me exist."

Johnson, a self-employed psychiatric nurse practitioner, is lucky in one respect: She has the money to pay for the policy, designed for people who are considered a high risk to insure. Many people with pre-existing conditions can't pay the sky-high costs, so they go without coverage.

That's something Obamacare will change. Starting Jan. 1, the only factors that will be considered for medical coverage in California are a person's age, income, ZIP code and household size. California even prohibits higher rates for smokers.

Soon after the Affordable Care Act was passed in 2010, children younger than 19 could no longer be refused insurance because of pre-existing conditions such as diabetes, cancer or asthma. Adults have been waiting patiently for their turn, and Johnson said it couldn't come soon enough because her savings are slowly being depleted. So she has been spending hours on the new health insurance website.

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While she and her husband make about $76,000 a year, medical and other deductions will probably make her eligible for a substantial subsidy. Even the most expensive plan on the exchange would cost her less than half what she pays now.

And that's for a policy that will have lower co-pays and deductibles and cover a lot more -- including prescription drugs.

"This could be such a relief for me," she said. "And countless other people."